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Clinical Crossroads
Clinician's Corner
March 2, 2011

Perinatal Care for Incarcerated PatientsA 25-Year-Old Woman Pregnant in Jail

JAMA. 2011;305(9):923-929. doi:10.1001/jama.2011.125

More than 6 million men and 1 million women are under US correctional control, be it jail, prison, probation, or parole. On any given day, about 250 000 women and adolescent girls are behind bars, a number well in excess of those documented for all other sovereign nations. Moreover, women and girls represent the fastest-growing segment of the prison and jail populations. Approximately 75% of these women are mothers of minor children (leaving 200 000 children “motherless”) and as many as 10 000 may be pregnant. Primarily designed for male offenders, the US correctional system is struggling to meet the specialized needs of its female inmates. Although incarceration during pregnancy is both stressful and dehumanizing, most studies paradoxically document better outcomes for pregnancies managed behind bars than for women of similar socioeconomic status whose pregnancies are managed in the community. Using the case of Ms A as a springboard for discussion, the issues, benefits, and challenges of caring for an incarcerated pregnant woman are addressed, as is the importance of family planning services to those about to be released.